175689 Chiropractor's role and patient compliance to health promotion advice: User's perspective

Monday, October 27, 2008: 12:30 PM

Harrison T. Ndetan, MSc, MPH, DrPH , Research, Parker College of Chiropractic, Dallas, TX
Sejong Bae, PhD , Department of Biostatistics, School of Public Health, UNT Health Science Center School of Public Health, Forth Worth, TX
Martha Felini, DC, PhD , Department of Epidemiology, University of North Texas Health Science Center, School of Public Health, Fort Worth, TX
Marion Willard Evans, DC, PhD, CHES , Cleveland Chiropractic College, Overland Park, KS
Ronald Rupert, MS, DC , Research Institute, Parker College of Chiropractic, Dallas, TX
Karan P. Singh, PhD , Department of Biostatistics, University of North Texas Health Science Center, School of Public Health, Fort Worth, TX

Health care provider's recommendation has been shown to be a predictor of future healthy behaviors. Patient adherence to these recommendations, however, may differ by health care professional type. We explored the use of health promotion recommendations and patients' compliance by United States' chiropractors and medical doctors.


Multiple logistic regression models were used for analyses of data from the Sample Adult Core component of the 2006 National Health Interview Survey (n=24,275). Analyses were performed separately for recommendation and compliance of weight loss, increase in exercise and diet change by health profession subtype (chiropractor and medical doctor).


Chiropractors gave health promotion recommendations to 20.9% (n=87) of the 417 patients they saw exclusively from medical doctors. The overall compliance rate to these recommendations by patients was 89.6% (n=78). Meanwhile, the medical doctors' recommendation rate was 38.9% (n=5502) of the 14201 patients they saw exclusively from chiropractors; with the patients' compliance rate of 88.15% (n=4850). Chiropractors were less likely to advice patients compared to medical doctors [adjusted OR(95%CI=0.38(0.30,0.50)]. In general, patients who received and complied with health promotion advice from their health care provider were more likely to report improved health status [adjusted OR(95%CI=1.21(1.10,1.33)] compared with those who did not comply.


Chiropractors in the United States give health promotion recommendation to their patients but are less likely to do so than general medical doctors. Patients tend to comply with health providers' recommendations and those who do tend to experience better health.

Learning Objectives:
To explore the use of health promotion recommendations and patientsí compliance by United Statesí chiropractors and medical doctors.

Keywords: Chiropractic, Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Investigator
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.